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Re: ACOG's VBAC statement revisited.From: Garry Siegel (garrys@mindspring.com)Mon Sep 25 11:59:46 2000
>> >>If I could get simple answers to the following questions I'd appreciate the >>effort. >> >>1. IN HOUSE ANESTHESIA YES/NO >> >>2. DEDICATED C/S OPERATING ROOM YES/NO >> >>3. IN HOUSE OPERATING ROOM CREW YES/NO >> >>4. HOW MUCH TYPE 0 Rh- BLOOD AVAILABLE AS A MINIMUM? >> 1. We notify the anesthesiologist of a laboring VBAC. We do not tell them how many docs/anesthetists to keep in house. When we pressed a bit for an inhouse person (let me clarify--there is always one, but if that one is tied up at 3 AM in an appendectomy, a second body isn't called in automatically, but if needed), the anesthesiologists reminded the Ob/Gyns that their ASA guidelines call for the Ob to inhouse during epidural placement. The reality is that we are next door in our office, or sometimes at home/OTW. We compromised, and informed them of the ACOG position. 2. Yes--but if there is a section in that OR, then the laboring VBAC goes to the main OR, where there always is a room. It would be a major cluster. . . 3. Yes, but again if the L and D crew is doing a section, and the OR crew an appendix (and this does happen a bit) at 3 AM, we've really not broached whether to call in yet another crew. 4. Who knows? PS--the above is for a small hospital, and the Ob docs think that this represents a reasonable, practical, if not perfect approach. Garry
-- Garry E. Siegel, M.D., F.A.C.O.G. Roswell, GA Private Practice
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